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Abstract Background Little is known about the nexus between online gambling and psychological distress among youth, especially in Ghana. This study aimed to investigate the effects of online sports betting on psychological distress, focusing on depression, anxiety, and stress among young individuals in the Volta region of Ghana. Methods A cross-sectional study was carried out at various betting centers in the Volta region of Ghana. Four hundred and three (403) participants were selected using a multi-stage sampling method. The study used a standardized questionnaire to assess psychological distress with the Depression, Anxiety, and Stress Scale (DASS 21) and problematic gambling with the Problem Gambling Severity Index (PGSI). The analysis included both descriptive and inferential methods. These include the implementation of the bootstrap technique within multiple regression models using the current versions of Jeffreys’s Amazing Statistics Program (JASP) [0.18.2], Statistical Package for the Social Sciences (SPSS) [29.0.2], and Microsoft Excel (2019). Results The study found a prevalence of 40% for problematic gambling and 44% for moderate gambling problems among participants, resulting in an overall gambling prevalence of 84%. Regarding psychological distress, the estimated prevalence of depression among participants was 43.6%, with stress reported at 31.1% and anxiety at 68.8%. The overall prevalence of psychological distress was 48%. When analyzing the link between gambling and psychological distress, the study noted that males were more prone to gambling-related psychological distress than females (β = 2.036, p = 0.025). Furthermore, individuals with problem gambling showed the highest probability of experiencing more significant psychological distress compared to other groups (β = 9.228, p = 0.002), followed by those with moderate gambling levels (β = 3.283, p = 0.002). Conclusion We recommend that the mental health unit of the Ghana Health Service, in collaboration with the Gaming Commission of Ghana, should develop youth-friendly interventions to address the prevalence and onset of problematic gambling among the youth, especially males. This could, in turn, reduce the prevalence of psychological distress among youth engaged in online gambling in Ghana.

Abstract Background Globally, there is a significant unmet need for the rapidly growing burden of Non-Communicable Diseases (NCDs). Ghana has adopted and implemented Wellness Clinics (WC) nationwide to respond to the rising burden of NCDs. Regrettably, very little is known about WCs, including their structure and the services they offer. This study explores the concept of WC, their structure, position within the hospital environment, and services from the perspectives of healthcare providers and clients. Methods An exploratory qualitative study was conducted with health professionals (n = 12) and clients (n = 26) of Wellness Clinics in two district hospitals and one regional hospital in a deprived region of Ghana where NCDs are rising. Using the WHO-PEN approach, an interview guide was purposely designed for this study. The data were analysed thematically using Atlas.ti. Results All three Wellness Clinics were sub-units under the outpatient department. The WC was created by the facilities to respond to the increase in NCDs and to meet annual performance review requirements. The Wellness Clinics provided NCD diagnosis, counselling, and treatment services to approximately 300 clients per week at the facility level. Only one of the WCs provided NCD prevention services at the community level. Integrated NCD care was also provided at the WC, despite the health system and individual-level challenges reported by the health workers and clients. Conclusion The implementation of the Wellness Clinic demonstrates the government’s commitment to addressing the increasing burden of NCDs in Ghana through the primary health system. To maximise the impact of the wellness clinics, we recommend developing best practices, providing logistics, and addressing health insurance challenges.

Objective This study explored the experiences of women who have undergone emergency caesarean section (EmCS) and how they perceived anxiety and depression to impact their quality of life.Design A qualitative study grounded in the biopsychosocial model was conducted among Ghanaian women diagnosed with anxiety and depression following EmCS. Semistructured interviews were used to collect data on the psychosocial impact of EmCS on women’s lives. Thematic analysis was used to identify key themes from the interviews, using Nvivo V.14 Software.Setting A hospital in Effutu Municipality, Central Region of Ghana. Data were collected from August 2022 to September 2023.Participants The study included 25 Ghanaian women who had undergone an EmCS, had clinically diagnosed and treated anxiety and/or depression and had recovered within the last 6 months. Women with pre-existing mental health conditions were excluded.Results The major themes identified from the thematic analysis of results included emotional distress, daily life challenges and disrupted social relationships.Conclusions There is an urgent need for targeted mental health interventions and culturally sensitive postpartum support to address the psychological needs of women following EmCS in Ghana.

Introduction: The demand and consumption of vegetables are significantly increasing worldwide, which has resulted in urban farming on anthropogenic sites. This study assessed the concentrations of some selected heavy metals in lettuce and spring onion in line with the WHO/FAO required standard and its implications on human health. Methods: The study was carried out in Kumasi, within moist semi-deciduous forest vegetation, Ghana. The digested samples were analyzed for heavy metals (Cu, Cr, Fe, Mg, Ni, and Zn) using atomic absorption spectrophotometer (AAS Model AA 400p). Analysis of variance was used to test the level of significance at α = .05. Results: The study found mean concentrations of chromium and iron in lettuce and spring onion to be below detection level (BDL) in all study sites based on WHO/FAO permissible level. Also, while copper in lettuce was BDL at all the sites, there were higher mean concentration of copper in spring onion at BSGS (131.5 ± 0.31 mg/kg) and BSG (120.8 ± 0.01 mg/kg). The mean concentration of nickel in lettuce (137.15 ± 0.0231) and spring onion (173.55 ± 0.02 mg/kg) at BSGS were higher than WHO/FAO permissible level. Mean concentration of zinc in both lettuce and spring onion were higher than WHO/FAO permissible level in all the study sites, except zinc in spring onion at KT. The ANOVA test statistics showed no significant difference among the concentrations of heavy metals in all sites, except zinc in lettuce and nickel in spring onion. The study found cancer risk factor for nickel, which exceeded the benchmark of 1 × 10 −6 for both lettuce and spring onion, indicating that long-term consumption could increase the risk of cancer in consumers. Conclusion: The study’s findings call for strict regulation and regular monitoring of heavy metals in vegetables cultivated at anthropogenic sites in urban areas to ensure food safety and consumer health.

Abstract The COVID-19 pandemic exposed long-standing inequities in Canada’s long-term residential care (LTRC) sector with life-threatening consequences. People from marginalized groups are overrepresented among those who live in, and work in LTRC facilities, yet their voices are generally silenced in LTRC research. Concerns about these silenced voices have sparked debate around ways to change LTRC policy to better address long-standing inequities and enhance the conditions that foster dignity for those who live and work in LTRC. Weaving an analysis of historical and cultural attitudes about LTRC, and promising strategies for engaging people with lived experience, we argue that the voices of people with lived experience of life and work (paid and unpaid) in LTRC are essential for ethically and effectively shifting long-standing inequities. Lessons from a 4-year, national, multi-disciplinary research study, known as the Seniors Adding Life to Years (SALTY) project, suggest that resident-determined quality of life can be prioritized by centring the perspectives of residents, their family/friends, direct care workers, volunteers, and people living with dementia in the research process. Accordingly, we highlight strategies to include these voices so that meaningful and impactful system change can be realized.

Antiretroviral therapy (ART) regimens in African countries, including Ghana, are often faced with the challenge of treatment default. To maximize ART utilization and efficiency among people living with HIV (PLHIV), it is pertinent to ensure that ART-related challenges that clients encounter are identified and addressed holistically. A phenomenological qualitative study of thirty participants recruited through the purposive sampling technique was conducted using in-depth interviews from June to July 2021. Independent coding was done using Atlas ti. Sub-themes were developed from the codes, using the most expressive phrases, and grouped under two broad themes, challenges, and opportunities to maximise ART uptake. Ten different challenges, grouped into the health system and individual constraints were reported. Health system constraints included stigmatisation and discrimination by healthcare workers, queuing outside while waiting to be served, long waiting periods, non-communication of laboratory test results to clients, lack of proper education on side effects associated with ART, and language barrier. Individual constraints included financial constraints, perceived non-improvement in health outcomes, food insecurity, and forgetfulness. Opportunities identified for improved ART uptake were assuring ART clients of improved health outcomes, leveraging the good rapport between ART clients and healthcare providers, leveraging the better counselling services offered to PLHIV at the ART clinic, provision of varied ART treatment regimens to clients, routine communication of laboratory test results to clients, and leveraging clients’ satisfaction with ART services at ART clinic. We recommend health system reforms targeting healthcare service delivery to PLHIV to encourage linkage, continuity, and retention in care and augmenting ART regimes with financial and nutritional support while encouraging status disclosure to a trusted family member.

Tricycles contribute to road crashes globally, especially in Asia where it is a popular means of transport. Safety assessment of tricycles has discovered that associated fatality rate and severity of injuries from tricycle crashes, which has risen steadily, are due to their flawed designs especially the absence of seatbelts and paddings of hard surfaces. Tricycle related crashes were sourced weekly from the regional office of the National Road Safety Authority from January 2012 to June 2022 and modelled with Autoregressive Integrated Moving Average Model. The results showed ARIMA (1,0,3) errors were retained as the best model for estimating road fatalities caused by tricycle crashes. The exogenous factors: tricycle crashes, time of day, season of the year, and road design were tested and found to be statistically significant relative to its contribution to the fatalities. The time series components were deemed to be relevant contributing factors to fatalities for the study period. Further, crash data forecasted to October 2022 largely exhibited a sinusoidal behaviour with spikes at various weeks. It was recommended that tricycle drivers undergo mandatory refresher courses on safe driving techniques and general road safety regulations as a policy intervention. In addition, the licensing regime for tricycles should be strengthened, and government should create separate lanes along some major routes within the metropolitan, municipal, and district assemblies to eliminate or reduce the negative incidents.

Expanding local rice production to meet consumer demand is a priority action under the Government of Ghana’s Planting for Food and Jobs initiative. While studies on yield-enhancing interventions abound, fewer studies focus on food safety issues (e.g., the potential toxic element status of the production ecosystems). This study was, therefore, conducted to bridge the knowledge gap. Chemical analyses were conducted on water, soil, and rice grain samples from different production ecosystems in the Northern and Upper East regions of Ghana. Statistical analysis of the data showed that soil and rice grain arsenic concentrations were significantly higher (P

Abstract Background Systems of across the world have developed and implemented patient rights policies to protect and improve the provider-patient relationship. The Patient Charter of Ghana was developed in 2002 to improve service quality and protect patients’ rights. However, it is not yet known whether those at the frontline of healthcare delivery can read and understand the contents of the charter. While studies have explored the socioeconomic and institutional level factors related to awareness and knowledge of the Patient Rights Charter, there is a lack of literature on its readability and comprehensibility among nurses. This study assesses nurses’ knowledge of the Patient Rights Charter and associated literacy-related factors. Method An exploratory cross-sectional design and quantitative methods were used to collect data on knowledge, comprehension, and readability of the Patient Rights Charter. 205 nurses from four district hospitals in the Central Region were recruited using proportional and total enumeration sampling. Data were collected using structured questionnaires and were processed using SPSS (version 26) and an online text readability consensus calculator (version 2.0). Descriptive and inferential statistical analyses were performed, and data were presented using simple frequencies, readability statistics, and regression output. Results The results show the charter is written at a higher reading grade level; Flesch-Kincaid Grade Level (13.36), Simple Measure of Gobbledygook (11.57), and Coleman-Liau Readability Index (14.2). The average reading grade level score was 14. The Gunning Fox Index (15.40) and the Flesch Reading Ease Score (34%) show the patient charter is difficult to read and will require at least 14 years of education to be able to read. 87.3% of nurses were able to read and comprehend the charter. Very few (8.3%) read at frustration level. Nurses’ actual comprehension of the charter was the only significant predictor of knowledge of the charter. Conclusion Comprehension of the patient charter is an important predictor of its knowledge. The results emphasize the need to enhance the readability and comprehensibility of the charter for providers. Hospitals can stimulate nurses’ knowledge of the charter by simplifying the charter’s language and deliberately educating nurses on its content.

Abstract Background The variations in health between rural and urban population have become an increasingly significant public health concern in developing countries including Ghana where urbanization is occurring. Whereas urbanization results in improved access to healthcare services, the concomitant negative consequences of urbanization coupled with unfavorable compositional and contextual attributes can affect the health of populations. The study sought to examine the effect of rural–urban residence and selected socio-demographic factors on perceived health state among aging population by employing a nationally representative data collected by the WHO from 2014 to 2015. Methods The data were derived from the WHO Study on Aging wave 2 released in 2019. A total of 4511 individuals, made up of 1018 adults between 18 and 49 years and 3493 respondents within the ages of 50 years and above, were involved in this study. The study examined the Spearman’s rho correlations between perceived health, rural–urban residence, age, sex, marital status, ever schooled, current work state, religion, and regional location. Subsequently, the study employed a multivariable ordinal logistic regression model to test the effect of the selected biosocial and contextual variables on perceived health state. Results The selected socio-demographic variables significantly correlated with health state, except for rural–urban residence. However, the predictive ability of rural–urban residence and the socio-demographic variables on perceived health state were strongly ascertained. It was observed that age, sex, rural–urban residence, and current state of work among aging populations were significant predictors of perceived health state as demonstrated by odds ratios and significant p values. The contextual factor of regional location was the most significant variable that increases the perceived health state of respondents in the study. Conclusions Continues engagement in work-related activities, an individual’s age within the aging continuum and regional location coupled with its environmental and ecological attributes, may significantly influence the development of positive perception toward health state, which forms a vital constituent of an individual health seeking behavior.

Abstract Background Continuous distribution channels are effective methods to deliver malaria interventions such as insecticide treated nets (ITNs) to pregnant women attending antenatal care clinics and children under five attending immunization visits. Facility-based and provider-based checklists were used during supportive supervision visits to measure the quality of facility-based services and interventions. This study looks at ITN distributions at health facilities in Ghana, with the aim of providing insights on how quality can be measured and monitored. Methods Various quality improvement approaches for malaria services occur in Ghana. Selected indicators were analysed to highlight the similarities and differences of how the approaches measured how well the channel was doing. Generally, the approaches assessed (1) service data management, (2) logistics data management, and (3) observation of service provision (ITN issuance, malaria education, ITN use and care education). Two approaches used a binary (Yes/No) scale, and one used a Likert scale. Results Results showed that most data reported to the national HMIS is accurate. Logistics data management remained an issue at health facilities, as results showed scores below average across facility stores, antenatal care, and immunization. Though the supervision approaches differed, overall results indicated that almost all eligible clients received ITNs, data were recorded accurately and reported on-time, and logistics was the largest challenge to optimal distribution through health facilities. Conclusion The supervision approaches provided valuable insights into the quality of facility-based ITN distribution. Ghana should continue to implement supportive supervision in their malaria agenda, with additional steps needed to improve reporting of collected data and increase the number of facilities visited for supportive supervision and the frequency. There were various supervision approaches used with no clear guidance on how to measure quality of facility-based ITN distribution, so there is also need for the global community to agree on standardized indicators and approaches to measuring quality of facility-based ITN distribution. Additionally, future studies can review the effect of multiple rounds of supervision visits on the quality of ITN distribution as well as understand the facilitators and barriers to scaling up supervision of facility-based ITN distribution.

Abstract Background Global efforts to reduce malaria burden include distribution of insecticide-treated mosquito nets through mass campaigns and routine channels. Ghana’s National Malaria Elimination Programme (NMEP) distributes insecticide-treated bed nets (ITNs) through various channels, including to pregnant women at antenatal care (ANC) visits and children at vaccination visits through child welfare clinics (CWC). This study assessed historical ITN distribution throughout ANCs and CWCs across Ghana and the characteristics of high performing facilities. Methods Monthly data on routine ITN distribution was provided from Ghana’s national health information management system for the years 2016–2021. Analyses were conducted to assess the performance of ITN distribution at ANC and CWC across time, ecological zone, regions, districts, facility ownership, and facility type. Univariate and multivariate logistic regressions were performed to predict the odds of ANC and CWC issuing rates greater or equal to 80% for a given facility type or ownership. Results In 2021, 93% of women who attended their first antenatal care visit and 92% of children under five who received their second dose of the measles-rubella vaccine (MR2) had received an ITN. At the regional level, 94% of regions (n = 15/16) maintained the NSP target issuing rate of 80% throughout 2020 and 2021. While there were no clear differences in issuing rates between ecological zones, district-level differences were present across the six years. All health facility types performed at or above 80% in 2021 for both ANC and CWC. Odds ratios demonstrated differences in the likelihood of meeting the 80% issuing rate goal among different facility types as well as private versus public ownership when comparing ANC and CWC. Conclusion By 2021, Ghana had improved its ITN issuing rates since the initial year of analysis, surpassing the 80% target by issuing nets to over 90% of pregnant women and young children attending ANC and CWC. Future work can explore the reasons for national and subnational differences in issuing rates as well as help understand additional characteristics of high performing facilities. Additionally, it is necessary to identify and expand on the drivers for improved performance over the time period.

Background Globally, one of the measures of high performing healthcare facilities is the compliance of patient safety culture, which encompasses the ability of health institutions to avoid or drastically reduce patient harm or risks. These risks or harm is linked with numerous adverse patient outcomes such as medication error, infections, unsafe surgery and diagnosis error.Objectives The general objective of this study was to investigate into the impact of patient safety culture practices experienced on patient satisfaction among patients who attend the Kwesimintsim Government Hospital in the Takoradi municipality.Methods This study was a descriptive cross-sectional study and a consecutive sampling technique was used to select 336 respondents for the study. Data was collected using a structured questionnaire and processed using Statistical Package for Social Sciences, V.21. Both descriptive and inferential statistics were carried out and result were presented using figures and tables.Results The study found that the overall patient safety compliance level observed by the respondents was poor (29.2%). The prevalence of adverse events experienced among the respondents was high (58%). The leading adverse events mentioned were medication errors, followed by wrong prescriptions and infections. The consequences of these adverse events encountered by the respondents were mentioned as increased healthcare costs (52%), followed by hospitalisation (43%), worsening of health conditions (41%) and contraction of chronic health conditions (22%). Patient safety cultural practices such as teamwork (β=0.17, p=0.03), response to error (β=0.16, p=0.005), communication openness (β=0.17, p=0.003) and handoffs and information exchange (β=0.17, p=0.002) were found to positively influence patient satisfaction.Conclusion The poor general compliance of the patient safety culture in the facility is unfortunate, and this can affect healthcare outcomes significantly. The study therefore entreats facility managers and various stakeholders to see patient safety care as an imperative approach to delivering quality essential healthcare and to act accordingly to create an environment that supports it.

IntroductionLesbian, gay, bisexual, transgender, and intersex (LGBTI) and related activities have been a topic of debate and discussion among policymakers and stakeholders, as well as common citizens in the African region, especially in Ghana. The current anti-LGBTI-related bill being put before Ghana's Parliament signifies the intensity of the issue. Even though some studies have looked at some aspects of the issue, no study presently has explored people's opinion on the passage of any future anti-LGBTI and related legislations in Ghana.AimThis study examined the perspective of tertiary-level students on the passage of anti-LGBTI legislation, as well as the non-physical factors that influence support for the passage of anti-LGBTI and related legislation in Ghana.MethodsThe study employed a quantitative cross-sectional design using 1,001 tertiary-level students. The study used convenience sampling technique with an online closed-ended, structured survey questionnaire as the main data collection instrument. The data was then analysed using Statistical Package for the Social Sciences, version 29 at a 5% significance level.ResultsThe results of the study indicated that majority of the respondents (81%) were in support of the passage of anti-LGBTI and related legislations. Their reasons included the health implications of LGBTI and related activities (63%), cultural and societal values (62%), religious reasons (54%), and western culture (25%). Also, almost half of the respondents (49%) held that health related perceptions about LGBTI have little or no empirical basis. The inferential analysis, further, revealed that even when age and sex assigned at birth are controlled, perceived health implications of LGBTI (β = 0.247, p = < .001), religious beliefs (β = 0.189, p = < .001), and cultural values (β = 0.218, p = < .001) positively predict the support for passage of anti-LGBTI legislation.ConclusionsPeople's level of support for the passage of anti-LGBTI legislation is influenced by several factors including religious beliefs, cultural values, and the perceived health implications of LGBTI. There is, however, the need for policy makers and other stakeholders to create awareness and educate the public about the various perceptions about LGBTI and related activities that are not scientifically legitimate.

Global sustainable development goals call for universal access to safely manage sanitation by 2030. Municipal solid waste separation and management is critical in Ghana as in other developing nations, yet Ghana generates about 12,710 tonnes of municipal solid waste per day, and the byelaws regarding waste management are seldom enforced. This paper investigated the willingness of Ghanaians to separate household solid waste for proper sustainable waste management. Data was collected using a structured questionnaire through an online survey for 30 days in June 2021 and responses from 1406 participants were analysed using SPSS v.26. The study found 92.2% of respondents (irrespective of educational status and dwelling unit type) agreeing to the assertion that existing waste separation and management practices contribute to environmental pollution. It also found that effort by authorities to manage waste was unsatisfactory. Further, 61% and 18% of respondents use refuse bins and plastic/polythene bags to temporarily store waste respectively while the rest used inappropriate storage receptacles. Only 41.8% of generated waste are collected and managed by waste management companies or through paid laborers yet some 65.3% preferred a door-to-door collection system. About 90.5% of respondents agreed that recycling household waste will drastically reduce pollution, 67.4% were aware of waste segregation and 72.1% were in favour of segregation if it was a requirement. Interestingly, the study established that educational status does not influence one's awareness of waste segregation (p-value =0.759), yet the educated class know that household waste can be recycled into other uses to reduce pollution (p-values (0.03, 0.025); Pearson R=6.99, 7.415). The study recommends awareness creation through public education and the provision of multiple waste bins to aid in waste separation

Transportation has contributed to the transformation of many economies, yet in Ghana, the challenges of transportation coupled with high youth unemployment has led to the introduction of auto-rickshaws (two- and three-wheeled carts) in the public transportation service in urban and rural communities alike. The focus of the paper is to analyse the economic impact of the rickshaw as a means of public transportation in Kumasi, Ghana. The study relied on structural equation modelling (SEM) to analyse both the direct and indirect economic impact of rickshaw riders. In all, a sample of 459 rickshaw riders in the Kumasi Metropolis were obtained through cluster and systematic sampling techniques. It was revealed that most rickshaw riders are youthful and mostly unmarried with their net daily income of about 14 times the daily minimum wage in Ghana which asserts its economic viability. Gender and education characteristics were similar to countries such as Nigeria, Somaliland, and India. The study found patronage of rickshaw services to be largely due to convenience, affordability and reliability. The direct economic impact of rickshaw as a means of public transport was higher that its indirect impact when type of patrons was utilized as a mediating factor. Safety issues and harassment from authorities were the biggest challenges found to be faced by rickshaw operators. Regulation of commercial rickshaw operations through a stringent licensing system, training, and enforcement of minimum age for operators were recommended among others. Additionally, the government can generate revenue from their activities through income tax, insurance and roadworthy renewals and license acquisition.

Objective Although several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MDR-TB in the Ashanti Region, Ghana.Design A retrospective, cross-sectional analysis.Setting The study was conducted in the Ashanti Region, the second most populous region in Ghana. The regional MDR-TB register, which contains information on all patients with MDR-TB being treated at the various TB centres in the region, was analysed between February and May 2021.Participants The participants consisted of all registered patients with MDR-TB who were placed on treatment between 1 January 2015 and 31 December 2020. Patients were included in the analysis if their treatment outcome had been assigned. Patients with no record of treatment outcome were excluded from the study.Outcome measures The main outcome variable for the study was MDR-TB treatment outcome, standardised as ‘cured’, ‘treatment completed’, ‘treatment failure’, ‘died’ and ‘lost to follow-up’. A logistic regression model was fitted for factors associated with the outcome measure.Results Out of 159 patients included in the analysis, 86 (54.1%) were declared cured, 28 (17.6%) completed their treatment successfully, 6 (3.8%) were declared treatment failure, 12 (7.5%) were lost to follow-up and 27 (17.0%) died. The overall treatment success rate was 71.7%. Patients who were female (adjusted OR (AOR)=1.27, 95% CI: 1.18 to 1.39, p=0.023), younger (AOR=0.53, 95% CI: 0.19 to 2.11, p=0.012), had a higher level of education (AOR=1.12, 95% CI: 0.65 to 1.90, p=0.034), had a baseline body mass index of 18.5 kg/m2 or above (AOR=1.57, 95% CI: 1.23 to 2.47, p=0.011) and those who did not have a history of TB (AOR=0.47, 95% CI: 0.10 to 0.75, p=0.028) were more likely to have successful MDR-TB treatment outcomes.Conclusions Favourable treatment outcomes for patients with MDR-TB can be achieved in a resource-limited country. Although the recommended WHO target of ≥75% was not met, the current result (71.7% treatment success rate) is still commendable considering all the challenges associated with TB treatment in Ghana.

A comparative experimental study on the effect of different cooking loads for two solar cooking pots incorporated with different thermal energy storage (TES) materials is presented. The pots have cavities in their walls for placing TES materials and are designed to be used with parabolic solar cookers. One pot is filled with erythritol as the TES material in the cavity, while the cavity of the other pot is filled with sunflower oil as the TES material. During the solar cooking period, the storage pots are heated up with solar energy, and cooking occurs as well as storage of thermal energy in the cavities of the pots. During the storage cooking period, the pots are placed in wonderbag slow cookers for off-sunshine cooking using the stored heat in the cavities. Water and sunflower oil with masses of 0.5,1.0, 1.5, 2.0, and 2.5 kg, respectively, are used as the cooking loads during both solar and storage cooking periods. The effect of the load is evaluated in terms of storage and heat utilisation efficiencies. The storage efficiencies marginally increase with the increase in the load when water is used as the heating load. The sunflower oil pot shows slightly higher storage efficiencies (3.2–4.4%) compared to the erythritol pot (2.5–3.9%) with water as the cooking load. Storage efficiencies using sunflower oil as the cooking load show slightly greater values compared to when using water and follow no particular trend with the increase in the mass of the load. Heat utilisation efficiencies increase with the load for both storage cooking pots and both cooking fluids. However, water shows higher heat utilisation efficiencies (erythritol-13-49%, sunflower oil-17-46%) compared to sunflower oil (erythritol-9.2–19%, sunflower oil-9.4–28%) during the heat utilisation experiments. The erythritol storage pot shows higher heat utilisation efficiencies compared to the sunflower pot when using water as the heating fluid. However, when using sunflower oil as the heating fluid, the sunflower oil pot shows higher heat utilisation efficiencies.

Abstract Background Insecticide-treated nets (ITNs) are one of the most cost-effective measures for preventing malaria. The World Health Organization recommends both large-scale mass distribution campaigns and continuous distributions (CD) as part of a multifaceted strategy to achieve and sustain universal access to ITNs. A combination of these strategies has been effective for scaling up ITN access. For policy makers to make informed decisions on how to efficiently implement CD or combined strategies, information on the costs and cost-effectiveness of these delivery systems is necessary, but relatively few published studies of the cost continuous distribution systems exist. Methods To address the gap in continuous distribution cost data, four types of delivery systems—CD through antenatal care services (ANC) and the expanded programme on immunization (EPI) (Ghana, Mali, and mainland Tanzania), CD through schools (Ghana and mainland Tanzania), and a combined community/health facility-based distribution (Zanzibar, Tanzania), as well as mass distributions (Mali)—were costed. Data on costs were collected retrospectively from financial and operational records, stakeholder interviews, and resource use surveys. Results Overall, from a full provider perspective, mass distributions and continuous systems delivered ITNs at overlapping economic costs per net distributed (mass distributions: 4.37–4.61 USD, CD channels: 3.56–9.90 USD), with two of the school-based systems and the mass distributions at the lower end of this range. From the perspective of international donors, the costs of the CD systems were, for the most part, less costly than the mass distributions (mass distributions: 4.34–4.55 USD, Ghana and Tanzania 2017 school-based: 3.30–3.69 USD, health facility-based: 3.90–4.55 USD, combined community/health facility 4.55 USD). The 2015 school-based distribution (7.30 USD) and 2016 health facility-based distribution (6.52 USD) programmes in Tanzania were an exception. Mass distributions were more heavily financed by donors, while CD relied more extensively on domestic resource contributions. Conclusions These results suggest that CD strategies can continue to deliver nets at a comparable cost to mass distributions, especially from the perspective of the donor.

Biomass and fossil fuels are mostly used in rural areas of developing countries for cooking. These energy resources have negative impacts on the environment and human health mainly due to deforestation and greenhouse gas emissions. A cleaner and environmentally-friendly form of cooking is solar cooking using the sun's energy. Parabolic solar cookers perform better than other solar cookers such as box solar cookers since higher temperatures are achieved in a shorter duration. These higher temperatures allow most types of cooking processes such as; boiling, frying, roasting, and baking to be possible. The major problem with most conventional solar cookers is that cooking is not possible during off-sunshine periods. Integrating solar cookers with thermal energy storage (TES) makes cooking during off-sunshine periods possible. This paper presents a comprehensive review of parabolic solar cookers with TES which is a sustainable cooking solution for developing countries. Previous work on both parabolic trough and parabolic dish solar cookers with TES is presented. Solar cookers with storage are classified according to the two main types of TES technologies which are; sensible heat thermal energy storage (SHTES) and latent heat thermal energy storage (LHTES). The main conclusions of the review are that; parabolic dish solar cookers with TES are more common than parabolic trough cookers, more studies have been done using latent heat storage as compared to sensible heat storage, limited modelling work has been presented, most of the parabolic cookers used aluminum sheets as the reflecting material, large scale experimental studies are limited and fewer studies tackled the techno-economic and socio-economic aspects. The review also highlights research gaps on parabolic solar cookers with TES in terms of the modelling, combined TES (sensible and latent heat), different reflector materials, large-scale experimental setups, and techno-economic and socio-economic analyses. Other important aspects to consider for parabolic solar cookers with TES include; the choice of sensible or latent heat storage materials, environmental impact, types of food to be cooked, and social acceptance.

Most solar cookers usually perform a single task of solely cooking food during sunshine hours. Solar cookers coupled with thermal energy storage (TES) material for off-sunshine cooking are usually expensive and require complex engineering designs, and cannot be used for dual purposes, for example, solar water heating and cooking. In this paper, a solar cooker that can perform dual tasks of cooking as well as storing thermal energy to be used during off-sunshine periods is presented. The experimental setup is composed of a parabolic dish, a solar receiver coupled with a flat plate and an oil-circulating copper coil for charging and discharging a storage tank. The objective of the experiment is to evaluate the energy and exergy thermal performance parameters of the dual-purpose system during charging and discharging cycles. The effect of the flow rate and the mass of the load are investigated while using sunflower oil as both the heat transfer fluid and the storage material. Charging and discharging experiments are conducted using four different flow rates (2, 3, 4, 5 mL/s), and with different masses (0.5, 1, 1.5, 2.0 kg) with water and sunflower oil as the test loads. The charging results show that the average energy and exergy rates as well as their corresponding efficiencies increase with an increase in the charging flow rate. On the other hand, the increase in the mass load tends to decrease marginally the average charging energy and exergy rates for water, and their corresponding efficiencies. For sunflower oil, the average charging energy and exergy rates and efficiencies showed a more pronounced decrease with an increase in the mass. Water generally shows higher charging and discharging energy and exergy efficiencies compared to sunflower oil with an increase in the flow rate. For discharging results, the correlations between the energy and exergy thermal performance parameters with respect to the flow rate and the heating load are not well defined possibly due to different initial storage tank temperatures at the onset of discharging and the inefficient discharging process which needs to be optimized in future.

Based on the requisition for an ideal precise power source for a hybrid electric emergency rescue vehicle (HE-ERV), we present an optimistic parameter matching and optimization schemes for the selection of a HE-ERV. Then, given a set of optimized power source components, they are classified into different types of HE-ERV. In this study, due to the different design objectives of different types of emergency rescue vehicles and the problems of hybrid electric vehicle parameter matching, a multi-island genetic algorithm (MIGA) and non-linear programming quadratic Lagrangian (NLPQL) is proposed for the matched parameters. The vehicle dynamic model is established based on the AVL Cruise simulation platform. The power source performance parameters are matched by theoretical analysis and coupled to the simulation platform. Finally, the optimized matched parameters are classified based on the support vector machines classification model to determine the category of the HE-ERV. The classification results showed that there is an unprecedented level for categorizing several factors of the power source parameters. This research showed that its more logical and reasonable to match HE-ERVs with medium motor/engine power output and battery capacity, as these can attain dynamic performance, extended driving range, and reduced energy consumption.

Coronavirus has spread worldwide with over 140 million cases and resulting in more than 3 million deaths between November 2019 to April 2021, threatening the socio-economic and psychosocial stability of many families and communities. There has been limited research to understand the consequences of COVID-19 on vulnerable populations in West Africa, and whether such consequences differ by countries' previous experience with Ebola. Using a media analysis of leading online news sources, this study identified the populations particularly vulnerable to the threats of the COVID-19 pandemic, described the consequences of COVID-19 experienced by these populations, and reported on the solutions to address them. All articles from the selected news sources published between January 1 and June 30, 2020 on 6 West African countries were imported into Dedoose. A total of 4,388 news articles were coded for excerpts on vulnerable populations, only 285 excerpts of which mentioned the existing effects of COVID-19 on vulnerable populations or implemented solutions. News articles from countries with past experience with Ebola were more likely to mention the pandemic's effects on vulnerable populations, especially on incarcerated people. Vulnerable groups were reported to have experienced a range of effects including economic disruptions, heightened domestic and sexual abuse, arbitrary arrests, health care inaccessibility, and educational challenges throughout the pandemic. With implications for the achievement of the Sustainable Development Goals (SDG) for 2030 in West Africa, these countries should consider and focus more strategic efforts on vulnerable populations to overcome their fight against the COVID-19 pandemic and to achieve the SDG for 2030.

Abstract Background Insecticide-treated nets are a key intervention for malaria prevention. While mass distribution can rapidly scale up ITN coverage, multiple channels may be needed to sustain high levels of ITN access and ownership. In Ghana’s Eastern Region, a continuous ITN distribution pilot, started in October 2012, 18–24 months after a mass campaign. The pilot distributed ITNs through antenatal care services (ANC), child welfare clinic services (CWC) through the Expanded Programme on Immunization, and to students in two classes of primary schools. Methods ITN ownership and access were evaluated through two cross-sectional surveys, conducted at baseline in April 2012, 11–15 months after the mass campaign, and at endline in December 2013, after 1 year of continuous distribution. A representative sample was obtained using a multi-stage cluster sampling design. Household heads were interviewed using a structured questionnaire. Results Household ownership of at least one ITN was 91.3% (95% CI 88.8–93.9) at baseline and was not statistically significant at endline 18 months later at 88.3% (95% CI 84.9–91.0) (p = 0.10). Ownership of at least 1 ITN per two people significantly decreased from 51.3% (95% CI 47.1–55.4) to 40.2% (95% CI 36.4–44.6) (p

Introduction: The demand and consumption of vegetables are significantly increasing worldwide, which has resulted in urban farming on anthropogenic sites. This study assessed the concentrations of some selected heavy metals in lettuce and spring onion in line with the WHO/FAO required standard and its implications on human health. Methods: The study was carried out in Kumasi, within moist semi-deciduous forest vegetation, Ghana. The digested samples were analyzed for heavy metals (Cu, Cr, Fe, Mg, Ni, and Zn) using atomic absorption spectrophotometer (AAS Model AA 400p). Analysis of variance was used to test the level of significance at α =.05. Results: The study found mean concentrations of chromium and iron in lettuce and spring onion to be below detection level (BDL) in all study sites based on WHO/FAO permissible level. Also, while copper in lettuce was BDL at all the sites, there were higher mean concentration of copper in spring onion at BSGS (131.5 ± 0.31 mg/kg) and BSG (120.8 ± 0.01 mg/kg). The mean concentration of nickel in lettuce (137.15 ± 0.0231) and spring onion (173.55 ± 0.02 mg/kg) at BSGS were higher than WHO/FAO permissible level. Mean concentration of zinc in both lettuce and spring onion were higher than WHO/FAO permissible level in all the study sites, except zinc in spring onion at KT. The ANOVA test statistics showed no significant difference among the concentrations of heavy metals in all sites, except zinc in lettuce and nickel in spring onion. The study found cancer risk factor for nickel, which exceeded the benchmark of 1 × 10−6 for both lettuce and spring onion, indicating that long-term consumption could increase the risk of cancer in consumers. Conclusion: The study's findings call for strict regulation and regular monitoring of heavy metals in vegetables cultivated at anthropogenic sites in urban areas to ensure food safety and consumer health. Plain language summary: The study assessed the concentrations of some selected heavy metals in lettuce and spring onion in line with the WHO/FAO required standard and its implications on human health. Why was the study done? The WHO recommends consuming at least 400 g fruits and vegetables each day to reap health and nutritional benefits. This has resulted in increased advocacy for vegetable consumption and production. However, farmlands have become very scare due to proliferation of illegal mining activities in Ghana, making urban anthropogenic sites the idea sites for farming. Meanwhile, these sites can have adverse effect on human health since it may contain heavy metals in the soil used for planting and this could be easily absorbed into the food chain, particularly for leafy vegetables such as lettuce and spring onion. What did the research do? The research team selected samples of lettuce and spring onion for laboratory analysis. The digested samples were analyzed for heavy metals; copper (Cu), chromium (Cr), iron (Fe), magnesium (Mg), nickel (Ni) and zinc (Zn); using atomic absorption spectrophotometer (AAS Model AA 400p) so that we can determine the presence of heavy metals in the leafy vegetables. What did the research find? The study found permissible level of chromium and iron in both lettuce and spring onion in all the study sites. Also, while copper in lettuce was within the permissible limit at all the sites, there were higher concentration of copper in spring onion at BSGS and BSG. Nickel concentration in lettuce and spring onion at BSGS were higher than WHO/FAO permissible level, however, in AH and KT, they were less than the permissible limit. There was high concentration of zinc in both lettuce and spring onion in all the study sites, except zinc in spring onion at KT. The ANOVA test statistics showed a significant difference among the concentrations of zinc in lettuce and nickel in spring onion. [ABSTRACT FROM AUTHOR]

Introduction: self-quarantine was one of the key public health interventions in halting the spread of the coronavirus disease (COVID-19) in Ghana. Despite its success, self-quarantine was bridled with challenges across the country, including in the Eastern Region. Consequently, it was pertinent to ascertain these challenges to inform future selfquarantine interventions in the region and the country. The study aimed to ascertain challenges faced by COVID-19 self-quarantined persons in the Eastern Region of Ghana to inform future policies on self-quarantine in the region and the country in general. Methods: thirty-five (35) participants were interviewed in both Twi and English. Following the thematic content analysis approach, Atlas. ti software was used to analyse the data. Relevant quotes were extracted from the transcripts to back the various sub-themes in presenting the results. Results: three global themes emerged from the analyses: socio-economic challenges of selfquarantine (lack of access to essential goods and services, loss of income, and poor housing conditions), health-related challenges (sedentary lifestyle, non-supply of essential personal protective equipment such as face masks, development of oedema and weight gain), and psychological challenges (loneliness, boredom, and anxiety). Conclusion: COVID-19-related challenges selfquarantined persons faced in the Eastern Region of Ghana were multifaceted, ranging from socioeconomic, and health to psychological ones. Consequently, emergency preparedness for future pandemic control using self-quarantine as a tool should bring on board various stakeholders to ensure challenges identified in this study are holistically addressed and do not recur. [ABSTRACT FROM AUTHOR]